SToP (See, Treat, Prevent) skin sores and scabies trial: study protocol for a cluster randomised, stepped-wedge trial for skin disease control in remote Western Australia

Introduction Skin is important in Australian Aboriginal culture informing kinship and identity. In many remote Aboriginal communities, scabies and impetigo are very common. Untreated skin infections are painful, itchy and frequently go untreated due to under-recognition and lack of awareness of thei...

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Main Authors: Marianne J Mullane, Timothy C Barnett, Jeffrey W Cannon, Jonathan R Carapetis, Ray Christophers, Juli Coffin, Frieda Mc Loughlin, Vicki O'Donnell, Rebecca Pavlos, Bec Smith, Andrew C Steer, Steven Y C Tong, Roz Walker, Asha C Bowen
Format: Article
Language:English
Published: BMJ Publishing Group 2019-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/9/e030635.full
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author Marianne J Mullane
Timothy C Barnett
Jeffrey W Cannon
Jonathan R Carapetis
Ray Christophers
Juli Coffin
Frieda Mc Loughlin
Vicki O'Donnell
Rebecca Pavlos
Bec Smith
Andrew C Steer
Steven Y C Tong
Roz Walker
Asha C Bowen
author_facet Marianne J Mullane
Timothy C Barnett
Jeffrey W Cannon
Jonathan R Carapetis
Ray Christophers
Juli Coffin
Frieda Mc Loughlin
Vicki O'Donnell
Rebecca Pavlos
Bec Smith
Andrew C Steer
Steven Y C Tong
Roz Walker
Asha C Bowen
author_sort Marianne J Mullane
collection DOAJ
description Introduction Skin is important in Australian Aboriginal culture informing kinship and identity. In many remote Aboriginal communities, scabies and impetigo are very common. Untreated skin infections are painful, itchy and frequently go untreated due to under-recognition and lack of awareness of their potential serious complications. We hypothesise that the skin infection burden in remote Aboriginal communities can be reduced by implementing streamlined training and treatment pathways integrated with environmental health and health promotion activities, tested in the See, Treat, Prevent (SToP skin sores and scabies) trial.Methods and analysis SToP will evaluate a skin control programme using a stepped-wedge, cluster randomised trial design with three intervention components (the ‘SToP activities’): (1) seeing skin infections (development of training resources implemented within a community dermatology model); (2) treating skin infections (employing the latest evidence for impetigo, and scabies treatment); and (3) preventing skin infections (embedded, culturally informed health promotion and environmental health activities). Four community clusters in the remote Kimberley region of Western Australia will participate. Following baseline data collection, two clusters will be randomly allocated to the SToP activities. At 12 months, the remaining two clusters will transition to the SToP activities. The primary outcome is the diagnosis of impetigo in children (5–9 years) at school-based surveillance. Secondary outcome measures include scabies diagnosis, other child health indicators, resistance to cotrimoxazole in circulating pathogenic bacteria, determining the economic burden of skin disease and evaluating the cost effectiveness of SToP activities.Ethics and dissemination This study protocol was approved by the health ethics review committees at the Child and Adolescent Health Service (Approval number RGS0000000584), the Western Australian Aboriginal Health Ethics Committee (Reference number: 819) and the University of Western Australia (Reference RA/4/20/4123). Study findings will be shared with community members, academic and medical communities via publications and presentations, and in reports to funders. Authorship for all publications based on this study will be determined in line with the Uniform Requirements for Manuscripts Submitted to Biomedical Journals published by the International Committee of Medical Journal Editors. Sharing results with organisations and communities who contributed to the study is paramount. The results of the SToP trial will be shared with participants in a suitable format, such as a single summary page provided to participants or presentations to communities, the Kimberly Aboriginal Health Planning Forum Research Subcommittee and other stakeholders as appropriate and as requested. Communication and dissemination will require ongoing consultation with Aboriginal communities to determine appropriate formats.Trial registration number ACTRN12618000520235.
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spelling doaj-art-9bac8fb3899b4a388811a8258fd9f6e82024-11-28T08:05:12ZengBMJ Publishing GroupBMJ Open2044-60552019-09-019910.1136/bmjopen-2019-030635SToP (See, Treat, Prevent) skin sores and scabies trial: study protocol for a cluster randomised, stepped-wedge trial for skin disease control in remote Western AustraliaMarianne J Mullane0Timothy C Barnett1Jeffrey W Cannon2Jonathan R Carapetis3Ray Christophers4Juli Coffin5Frieda Mc Loughlin6Vicki O'Donnell7Rebecca Pavlos8Bec Smith9Andrew C Steer10Steven Y C Tong11Roz Walker12Asha C Bowen131 Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, AustraliaWesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, AustraliaWesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia3 Department of Paediatric Infectious Diseases, Perth Children’s Hospital, Nedlands, Western Australia, Australia4 Nirrumbuk Environmental Health & Services, Nirrumbuk Aboriginal Corporation, Broome, Western Australia, AustraliaNgangk Yira Institute for Change, Yawardani Jan-ga Research Centre, Murdoch University, Broome, WA, Australia1 Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, AustraliaKimberley Aboriginal Medical Services, Broome, Western Australia, AustraliaWesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia8 Western Australian Country Health Services—Kimberley, Broome, Western Australia, AustraliaDepartment of Paediatrics, University of Melbourne, Parkville, Victoria, AustraliaDepartment of Infectious Diseases, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia1 Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Nedlands, Western Australia, AustraliaMedical School, Paediatrics, The University of Western Australia, Perth, WA, AustraliaIntroduction Skin is important in Australian Aboriginal culture informing kinship and identity. In many remote Aboriginal communities, scabies and impetigo are very common. Untreated skin infections are painful, itchy and frequently go untreated due to under-recognition and lack of awareness of their potential serious complications. We hypothesise that the skin infection burden in remote Aboriginal communities can be reduced by implementing streamlined training and treatment pathways integrated with environmental health and health promotion activities, tested in the See, Treat, Prevent (SToP skin sores and scabies) trial.Methods and analysis SToP will evaluate a skin control programme using a stepped-wedge, cluster randomised trial design with three intervention components (the ‘SToP activities’): (1) seeing skin infections (development of training resources implemented within a community dermatology model); (2) treating skin infections (employing the latest evidence for impetigo, and scabies treatment); and (3) preventing skin infections (embedded, culturally informed health promotion and environmental health activities). Four community clusters in the remote Kimberley region of Western Australia will participate. Following baseline data collection, two clusters will be randomly allocated to the SToP activities. At 12 months, the remaining two clusters will transition to the SToP activities. The primary outcome is the diagnosis of impetigo in children (5–9 years) at school-based surveillance. Secondary outcome measures include scabies diagnosis, other child health indicators, resistance to cotrimoxazole in circulating pathogenic bacteria, determining the economic burden of skin disease and evaluating the cost effectiveness of SToP activities.Ethics and dissemination This study protocol was approved by the health ethics review committees at the Child and Adolescent Health Service (Approval number RGS0000000584), the Western Australian Aboriginal Health Ethics Committee (Reference number: 819) and the University of Western Australia (Reference RA/4/20/4123). Study findings will be shared with community members, academic and medical communities via publications and presentations, and in reports to funders. Authorship for all publications based on this study will be determined in line with the Uniform Requirements for Manuscripts Submitted to Biomedical Journals published by the International Committee of Medical Journal Editors. Sharing results with organisations and communities who contributed to the study is paramount. The results of the SToP trial will be shared with participants in a suitable format, such as a single summary page provided to participants or presentations to communities, the Kimberly Aboriginal Health Planning Forum Research Subcommittee and other stakeholders as appropriate and as requested. Communication and dissemination will require ongoing consultation with Aboriginal communities to determine appropriate formats.Trial registration number ACTRN12618000520235.https://bmjopen.bmj.com/content/9/9/e030635.full
spellingShingle Marianne J Mullane
Timothy C Barnett
Jeffrey W Cannon
Jonathan R Carapetis
Ray Christophers
Juli Coffin
Frieda Mc Loughlin
Vicki O'Donnell
Rebecca Pavlos
Bec Smith
Andrew C Steer
Steven Y C Tong
Roz Walker
Asha C Bowen
SToP (See, Treat, Prevent) skin sores and scabies trial: study protocol for a cluster randomised, stepped-wedge trial for skin disease control in remote Western Australia
BMJ Open
title SToP (See, Treat, Prevent) skin sores and scabies trial: study protocol for a cluster randomised, stepped-wedge trial for skin disease control in remote Western Australia
title_full SToP (See, Treat, Prevent) skin sores and scabies trial: study protocol for a cluster randomised, stepped-wedge trial for skin disease control in remote Western Australia
title_fullStr SToP (See, Treat, Prevent) skin sores and scabies trial: study protocol for a cluster randomised, stepped-wedge trial for skin disease control in remote Western Australia
title_full_unstemmed SToP (See, Treat, Prevent) skin sores and scabies trial: study protocol for a cluster randomised, stepped-wedge trial for skin disease control in remote Western Australia
title_short SToP (See, Treat, Prevent) skin sores and scabies trial: study protocol for a cluster randomised, stepped-wedge trial for skin disease control in remote Western Australia
title_sort stop see treat prevent skin sores and scabies trial study protocol for a cluster randomised stepped wedge trial for skin disease control in remote western australia
url https://bmjopen.bmj.com/content/9/9/e030635.full
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